Journal of Clinical Pathology最新文献

{"title":"Adding interpretative comments to results of thyroid function tests from patients on thyroxine replacement does not improve management.","authors":"Amy Mallorie, Tim James, Sureshni deFonseka, Gayani Weerasinghe, Dave Green, Brian Shine","doi":"10.1136/jcp-2025-210174","DOIUrl":"https://doi.org/10.1136/jcp-2025-210174","url":null,"abstract":"<p><strong>Aims: </strong>To assess the impact of adding clinical comments to reports of thyroid function testing in patients treated for hypothyroidism.</p><p><strong>Methods: </strong>We compared thyroid function test results in primary care patients being treated for hypothyroidism from January 2016 to August 2023 at two NHS Trusts with similar demographics and using the same instruments, but with different interpretative comment policies. One laboratory, Buckinghamshire Health Trust (Bucks), adds interpretative comments, whereas the other, Oxford University Hospitals (Oxford), does not. We used two outcome measures: the percentage of patients with thyroid-stimulating hormone (TSH) within the reference interval on repeat testing and the timing of repeat TSH testing samples, according to the National Institute for Health and Care Excellence guidance (NG145).</p><p><strong>Results: </strong>We identified 18 242 and 31 655 hypothyroid patients (9.0% and 7.7% of the population tested) in Bucks and Oxford, with a total of 121 961 and 247 639 tests over the evaluation period, respectively. The proportion of TSH results within the reference interval (83.4% in Bucks, 83.9% in Oxford) was similar in both Trusts, as was TSH concentration (median TSH concentration 1.60 (IQR 0.78-2.82) mU/L in Bucks, 1.68 (IQR 0.97-2.76) in Oxford). The interval between tests was shorter in Oxford, but differed significantly from NG145 in both Trusts. Differences were statistically significant for both outcome measures, but of questionable clinical significance.</p><p><strong>Conclusions: </strong>Adding interpretative comments to results of thyroid function tests does not appear to affect the distribution of TSH concentrations in primary care patients on thyroxine replacement or the intervals between tests in a clinically meaningful way.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative evaluation of sentinel lymph nodes in patients with breast cancer treated with systemic neoadjuvant therapy: a systematic review and meta-analysis of diagnostic studies.","authors":"Mariela Huerta-Rosario, Carlos Quispe-Vicuña, Dante Julca-Marín, Carlos J Zumaran-Nuñez, Hans Baltazar-Ñahui, Luis M Acuña-Chávez, Fiorella Medina-Navia, Wendy Nieto-Gutierrez, Carlos Alva-Diaz, Sunati Sahoo","doi":"10.1136/jcp-2025-210078","DOIUrl":"https://doi.org/10.1136/jcp-2025-210078","url":null,"abstract":"<p><strong>Background: </strong>Frozen section (FS) and touch imprint (TI) are common intraoperative evaluation (IOE) techniques for sentinel lymph nodes (SLNs) in breast cancer surgery. Their accuracy in patients receiving neoadjuvant systemic therapy (NST) remains variable.</p><p><strong>Objective: </strong>To summarise evidence on the diagnostic accuracy of FS and TI in the NST context.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Scopus and Web of Science was conducted through April 2024 for studies evaluating FS and/or TI in SLNs of breast cancer patients treated with NST. Meta-analysis was performed using the logit function, and Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies-2 and Grading of Recommendation, Assessment, Development and Evaluation were employed to assess risk of bias and evidence certainty.</p><p><strong>Results: </strong>20 studies were included. At the lymph node level, TI demonstrated pooled sensitivity and specificity of 0.54 and 1.00, respectively, while FS achieved 0.85 and 0.99. At the patient level, TI showed sensitivity and specificity of 0.72 and 1.00, while FS reached 0.82 and 0.98. Combined, FS and TI presented pooled sensitivity and specificity of 0.59 and 1.00 at the patient level. Risk of bias was frequently unclear, and the certainty of evidence for both techniques ranged from low to very low.</p><p><strong>Conclusion: </strong>FS exhibits higher sensitivity and specificity than TI at both lymph node and patient levels, but evidence certainty remains limited. Further prospective, blinded studies are needed to validate these findings and optimise IOE methods for NST-treated patients.</p><p><strong>Prospero registration number: </strong>CRD42023483079.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixative faux pas: glutaraldehyde's limitation in imaging mass cytometry studies of kidney biopsies.","authors":"Mariam Priya Alexander, Kevin Pavelko, Michael Strausbauch, Vidhya Dharshini Murugesan, Taxiarchis Kourelis, Trevor Mckee, Timucin Taner","doi":"10.1136/jcp-2025-210258","DOIUrl":"10.1136/jcp-2025-210258","url":null,"abstract":"","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of non-<i>Helicobacter pylori Helicobacter</i> (NHPH) species in <i>H. pylori</i>-associated gastritis.","authors":"Yi Fan Chen, Aditi Tayal, Kenneth Friedman, Navid Sadri","doi":"10.1136/jcp-2025-210346","DOIUrl":"https://doi.org/10.1136/jcp-2025-210346","url":null,"abstract":"<p><p><i>Helicobacter pylori</i> is a well-established cause of gastritis and gastric malignancy, but other <i>Helicobacter</i> species-collectively termed non-<i>Helicobacter pylori Helicobacter</i> (NHPH)-also contribute to gastric disease. This study retrospectively analysed the prevalence of NHPH in 1115 routine gastric biopsies from a large academic medical centre submitted for <i>H. pylori</i> drug susceptibility genotyping using a next-generation sequencing (NGS) assay targeting <i>16S</i> and <i>23S</i> rRNA genes. NGS results of identified pathogens were compared against those identified on histology. NHPH species were detected in 15 of 1115 cases (1.3%), including 7 NHPH-only infections and 8 mixed infections with <i>H. pylori</i> Detected NHPH species included <i>Helicobacter heilmannii</i>, <i>Helicobacter felis</i> and <i>Helicobacter bizzozeronii</i> No mutations associated with antimicrobial resistance were identified in NHPH. Broader molecular testing may improve recognition of mixed infections and guide more accurate diagnosis and treatment for gastric disease.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EBV-positive Burkitt lymphoma arising in a patient with chronic lymphocytic leukaemia/small lymphocytic lymphoma: a case report.","authors":"Chen Chang, Bo-Yu Huang, Ya-Ping Chen, L Jeffrey Medeiros, Kung-Chao Chang","doi":"10.1136/jcp-2025-210274","DOIUrl":"https://doi.org/10.1136/jcp-2025-210274","url":null,"abstract":"","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymph node threshold in colorectal cancer: surgeons' perspectives and practices.","authors":"Nandan Padmanabha, Yevgen Chornenkyy, Wenyu Pan, Monika Vyas, Osman Yilmaz","doi":"10.1136/jcp-2025-210290","DOIUrl":"10.1136/jcp-2025-210290","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines emphasise examining at least 12 lymph nodes (LN) in colorectal cancer resections. This study surveyed surgeon perspectives on suboptimal LN yield (<12) to assess interpretive variability and beliefs regarding its clinical impact.</p><p><strong>Methods: </strong>A voluntary 19-question electronic survey was distributed to colorectal and general surgeons, exploring clinical, pathological and molecular considerations in cases with low LN yield.</p><p><strong>Results: </strong>Among 168 respondents (58% colorectal surgeons; 32% general surgeons), most practised in academic or mixed settings, and 73% had over 10 years of experience. While 71% reported suboptimal LN yields as infrequent, 29% encountered them more regularly. A majority (92%) contacted pathology when LN yield was low; however, opinions diverged on next steps-particularly when maximum N-stage was already achieved or when considering total fat submission. Nearly half (49%) believed that low LN yield rarely alters treatment decisions, yet many acknowledged its association with poorer outcomes. Regarding potential contributing factors, 56% cited neoadjuvant therapy, 47% noted specimen length or sidedness, but most did not consider mismatch repair status, age or body mass index to significantly impact LN yield.</p><p><strong>Conclusion: </strong>Despite the '12-node rule', surgeon perspectives vary regarding the significance, aetiology and clinical consequences of suboptimal LN yield. The overarching message for pathology is that thoughtful communication among surgeons and pathologists is critical to understand the idiosyncrasies around individualised care and nuances around factors that may influence LN yield, with the ultimate hope to best manage resources and optimise patient care.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"673-677"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric Crohn's disease: histologic findings at initial presentation.","authors":"Smiljana Spasic, Amaya Pankaj, Jess L Kaplan, Deepa Patil, Christopher J Moran, Vikram Deshpande","doi":"10.1136/jcp-2024-209535","DOIUrl":"10.1136/jcp-2024-209535","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing paediatric Crohn's disease (CD) based on histology can present challenges. We evaluate the histological spectrum of treatment-naïve biopsies from children with CD and assess these findings' diagnostic and predictive value.</p><p><strong>Methods: </strong>Three cohorts were identified: (1) 137 patients with CD, (2) 116 patients with ulcerative colitis (UC) and (3) 50 patients without inflammatory bowel disease. Biopsies from the gastrointestinal (GI) tract were re-examined for signs of active and chronic inflammation, including lymphocyte-pattern oesophagitis, focal enhancing gastritis and indicators of chronicity. Additionally, granulomas and microgranulomas (defined as clusters of 4-9 epithelioid histiocytes) were evaluated.</p><p><strong>Results: </strong>Lymphocyte-pattern oesophagitis was observed in 15% of patients (n=20). Moderate-to-severe diffuse gastritis was noted in 50.4% of patients (n=68), while focal enhancing gastritis was identified in 11.1% (n=15). In terminal ileal biopsies, 46.1% exhibited activity and 5.3% showed features of chronicity. Active colitis was present in 73% of patients (n=100), with chronic colitis seen in 11.7% (n=16). Granulomas and microgranulomas were observed in 31.4% (43/137) and 48.9% (67/137) of patients, respectively. Notably, 30.7% (42/137) of patients with microgranulomas were without granulomas. Previously undetected microgranulomas were found in 20 of 27 cases. 2.5% of patients with UC and none of the control cohort showed microgranulomas. Lymphocyte-pattern oesophagitis was associated with an increased need for anti-tumor necrosis factor (TNF) therapy (p=0.007).</p><p><strong>Conclusions: </strong>GI microgranulomas, often overlooked, are specific to CD in the proper clinical context. Oesophageal lymphocytosis may predict a need for more aggressive treatment. The study brings to light under-recognised aspects of CD's histological diagnosis, including the oversight of microgranulomas, the high prevalence of diffuse gastritis and low prevalence of focal enhancing gastritis, the frequent absence of terminal ileitis and the infrequent occurrence of chronic colitis.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"659-666"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological significance and prognostic analysis of p21 and EGFR in colorectal cancer: a retrospective analysis on 12 319 cases in China.","authors":"Yang Fei, Mengke Ma, Lu Gan, Midie Xu, Yu Yang, Dan Huang, Weiqi Sheng","doi":"10.1136/jcp-2024-209450","DOIUrl":"10.1136/jcp-2024-209450","url":null,"abstract":"<p><strong>Aims: </strong>Colorectal cancer (CRC) is the third most common malignancy worldwide. Accurate pathological diagnosis and predictive abilities for treatment response and prognosis are crucial for patients with CRC. This study aims to analyse the expressions of p21 and EGFR in CRC and their relationships with clinicopathological characteristics and prognosis to enhance diagnostic and prognostic evaluations.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of p21 and EGFR expressions in 12 319 Chinese patients with CRC using immunohistochemistry. The relationships between these expressions and clinicopathological characteristics and survival outcomes were explored through statistical and survival analyses.</p><p><strong>Results: </strong>Differential expressions of p21 and EGFR in CRC were closely related to clinicopathological characteristics and significantly impacted overall survival (OS). p21 expression was associated with the primary tumour site, mucinous subtype, lymphovascular invasion, perineural invasion, circumferential resection margin, T stage, N stage, tumour, node, metastases (TNM) stage, and mismatch repair status. EGFR expression was related to mucinous subtype, tumour differentiation, lymphovascular invasion, perineural invasion, tumour size, T stage, N stage, TNM stage and <i>BRAF</i> gene mutation. p21 and EGFR expressions were positively correlated (r=0.11). High p21 expression correlated with favourable OS, whereas high EGFR expression predicted poorer OS. A prognostic nomogram incorporating these biomarkers and clinical variables demonstrated robust predictive power for patient survival rates.</p><p><strong>Conclusion: </strong>p21 and EGFR serve as potential indicators for pathological diagnosis, risk stratification, and predicting treatment efficacy and prognosis in patients with CRC. The study's findings provide valuable references for personalised treatment and prognosis evaluation in clinical practice.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"667-672"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of quality checks and processes across digital histopathology: an initial survey from the Bigpicture consortium.","authors":"Hayley Pye, David S Brettle, Caitríona Lyons, Fauve Versaevel, Erio Barale-Thomas, Kurt Zatloukal, Darren Treanor","doi":"10.1136/jcp-2024-210010","DOIUrl":"10.1136/jcp-2024-210010","url":null,"abstract":"<p><strong>Aims: </strong>In the end-to-end digital pathology workflow, variability can be introduced at each step, resulting in differences in the final image dataset. The effectiveness of quality control processes at each step of the workflow will impact the extent and relevance of this variability.</p><p><strong>Methods: </strong>To assess the maturity of whole slide imaging (WSI) quality processes for the whole digital pathology workflow, we conducted an online questionnaire across 19 digitally active members of the Bigpicture consortium.</p><p><strong>Results: </strong>A key finding was that a lower proportion of centres are implementing rigorous quality processes and checks processes at the post-scanning steps of the WSI workflow, such as 'digital reporting and display' (44%) and computational analysis (34%), when compared with pre-scanning steps such as 'pre-staining' (72%) and 'staining' (77%).</p><p><strong>Conclusions: </strong>This information allows us to identify priorities for quality improvement of the overall WSI workflow.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"691-696"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can polycythaemia vera disease be predicted from haematologic parameters? A machine learning-based study.","authors":"Murat Haskul, Emin Kaya, Ahmet Kurtoğlu","doi":"10.1136/jcp-2025-210087","DOIUrl":"10.1136/jcp-2025-210087","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this research is to diagnose polycythaemia vera (PV) disease using different machine learning (ML) algorithms with complete blood count (CBC) parameters before further investigations such as Janus kinase 2 (<i>JAK2</i>), erythropoietin (EPO) and bone marrow biopsy (BMB).</p><p><strong>Methods: </strong>The study included 1484 patients who presented to the adult haematology clinic with elevated haemoglobin. Participants were retrospectively screened for <i>JAK2</i>, EPO and BMB results, and patients were categorised as PV group (n=82) and non-PV (other) (n=1402). First, the synthetic minority oversampling technique (SMOTE) method was used to avoid data imbalance. Then, classification predictions were made using Random Forest, Support Vector Machine Technique, Extreme Gradient Boosting (XGBoost) and K-Nearest Neighbours algorithms according to the participants' CBC parameters of white cell count (WBC), haematocrit (HCT), haemoglobin (HGB) and platelet (PLT).</p><p><strong>Results: </strong>The XGBoost algorithm was found to be the most effective ML algorithm in predicting the model (area under the curve=0.99, accuracy=0.94, F1-Score=0.94). In addition, the most effective parameter in the prediction of the model was PLT with 42.4%. As a result of the t-test, there was a highly significant difference between the WBC, PLT, HGB, HCT, EPO, <i>JAK2</i> and bone marrow density results of PV and other groups (p<0.001).</p><p><strong>Conclusion: </strong>ML algorithms can diagnose PV with CBC parameters with high accuracy, thus emphasising the potential to reduce the dependence on costly diagnostic methods such as <i>JAK2</i>, EPO and BMB.</p>","PeriodicalId":15391,"journal":{"name":"Journal of Clinical Pathology","volume":" ","pages":"684-690"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12505070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}